Patients' Perceive Biologics to Be Riskier and More Dreadful Than Other IBD Medications

Koliani-Pace JL1, Haron AM1, Zisman-Ilani Y2, Thompson KD1, Siegel CA1. Inflamm Bowel Dis. 2019 Jul 13. pii: izz121. doi: 10.1093/ibd/izz121. [Epub ahead of print]


Author information

Dartmouth-Hitchcock Inflammatory Bowel Disease Center, Section of Gastroenterology and Hepatology, Dartmouth-Hitchcock Medical Center, Lebanon, NH.

College of Public Health, Temple University, Philadelphia, PA.


BACKGROUND: Biologic medications have advanced the management of inflammatory bowel diseases (IBD) but are underutilized in the treatment algorithm. One reason may be related to patients' concerns about adverse events and their perceptions of risk. The aim of this study was to compare patients' perceptions of risk of IBD treatment with their perceived risk of everyday occurrences and other medications and how these perceptions may be influenced by personality traits.

METHODS: A cross-sectional study of consecutive IBD patients was conducted at a single tertiary care center. Participants were asked to report about their perception of risk of IBD medications, non-IBD medications, invasive procedures, and everyday life occurrences. Participants responded also to the Multidimensional Health Locus of Control (MHLC) scale to characterize beliefs about control over health outcomes.

RESULTS: A total of 130 patients with IBD completed the questionnaires. There was a broad range of disease severity and prior medication use. Biologics elicited the highest dread of all IBD medications, but this was still lower than their fear of surgery. Patients believed that biologics were of higher benefit than immunomodulators and mesalamines, but riskier. Having the personality trait of an internally developed locus of control was associated with the perception that biologics are less dreadful.

CONCLUSIONS: Patients with IBD perceive biologics to be of higher benefit but riskier and more dreadful as compared with immunomodulators. Risk perception may be about more than their knowledge base but also about how much control patients typically believe they have over their daily lives.

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